甲状腺肿英文.pptVIP

The physiological functions of thyroid gland Synthesize, reserve and secrete thyroxine 3,5,3’,5’-tetraiodothyronine, T4 3,5, 3’-triiodothyronine , T3 Synthesis of thyroid hormones Concentrates iodine Organification : iodine oxidation and its incorporation into tyrosine to form monoiodotyrosine (MIT) and diiodotyrosine (DIT) Coupling: T4 and T3 arise from the coupling of either 2 DIT residues or 1 MIT and 1 DIT residue (requires thyroid peroxidase) Circulating T4 and T3 Thyroid hormones exist in two forms, free and protein bound the free hormone concentration determines the thyroid status irrespective of the total plasma concentration the total hormone is determined by thyroxine-binding globin (TGB) and albumin. thyroxine-binding globin (TGB) Increased TBG 1.???Pregnancy 2. Treatment with supraphysiologic amounts of estrogens,雌激素类including oral contraceptives.口服避孕药 3.????In some patients with cirrhosis or acute hepatitis ? Decreased TBG 1. Protein malnutrition, hepatic failure, chronic illness 2. Nephrotic syndrome 3. During treatment with androgenic steroids 雄激素or pharmacologic药理学doses of glucocorticoids Tests of thyroid function Measurement of total serum thyroid hormone concentrations Serum free T4 and T3 concentrations Radioactive iodine uptake Tests of thyroid regulation Serum thyrotropin Etiology and pathogenesis endemic goiter：iodine deficiency Etiology and pathogenesis Sporadic goiter 1. diet iodine Substances leading thyroid gland intumescence 2. drugs 3. heredity 4. immunity Clinical manifestations Simple thyroid gland intumescence，usually asymptomatic，sever intumescence can cause press symptome I: diameter3cm II: diameter 3-5 cm III: diameter 5-7 cm IV: diameter 7-9 cm V: diameter 9cm Diagnosis and differential diagnosis Diagnosis thyroid gland intumescence (diffuse or/and nodular)，the function of thyroid gland normal , antibodies against oneself are negative Diffe